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HomeMy WebLinkAbout23616-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT - office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25913 Date: 08/24/98 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 2072 VILLAGE LA ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 24 Block 2 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1996 pursuant to which Building Permit No. 23616-Z dated AUGUST 5, 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION & ALTERATION TO AN EXISTING SEASONAL MULTIPLE DWELLING (REDUCING 5 UNITS TO 4) & DECK ADDITIONS AS APPLIED FOR & AS PER ZBA #4331 The certificate is issued to DAVID & CLARE L AIR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 08/17/96 PLUMBERS CERTIFICATION DATED 07/29/98 KING PLUMBING / R AuA din Inspector 7 Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N .O 23616 Z Date .... .. ........ ............................... ) .. Permission is hereby granted to: ............... . ... e ................ ° 3 .... .. ..... ... ...:................. toy v F :............ ...: . � b , , ; ... . ,A... .... ... . ,dam %7w �` s. %. of premises located ateClta.et ...........�..,../ R...V........... / .............................................................. ;�P�3.. ......................................................y.............. County Tax Map No. 1000 Section .........e ..... Bllossck ......A........... Lot No. ...."/.1.............. pursuant to application dated ........... ..../P.................... 19 . , and approved by the Building Inspector. Fee $ / ........... ................ ............. ... . ... . Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - .25�_ Updated Certificate of Occupancy - $50.00 `5 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .�\ J \ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. :. . . . . . . . . . . . . _ Location of Property. :�C))Al. . .v\LLAh� Lfy1JE �Z\LTJ ���5 . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. -:� �5. . :!.�i�.x . ;�X\.z . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . County Tax Map No 1000, Section. .Z:�l. . . . . . . .Block. . . !�Z . . . . . . . .Lot. . . a.. . . . . . . . .. ...., . . . s. Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . .yspp.tt. .Filed Map. . . . . . . . . . . .Lot. . . . . . ... . . . . . . . .n. Z .. . Permit No.�3�?��' . . . . .Date Of Permit. .�.0 W . . . . . . . .Applicant. . . ClA2E,�. .�J�j�`l\�, }�� Health Dept. Approval. . . . . . . . . . . . . . .1,A . . . .. . .Underwriters Approval. . . . . . . . . . . ( Planning Board Approval. . . . . . . . . .. . . . . . . . . . . . . . iRequest for: Temporary Certificate. . f. . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $�J..00 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `. . . . . . . . . . . . . . . . . . . . _�7 APPLICANT T---fte Cd %500 APPEALS BOARD MEMBERS Southold Town Hall Gerard R Goehringer, Chairman x133095 Main Road Serge Doyen, Jr. RO,. Box 1179 James Dinizio, Jr. ®F9o0 .o&u New York 11971 Robert A. Villa Fax(516)765-1823 Lydia A. Tortora Oj �O Telephone(516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD OF APPEALS Appl. No. 4331: Matter of the Application of DAVID AND, CLAIRE AIR. Variances based upon the August 1, 1995 Notice of Disapproval issued by the Building Inspector under the Zoning Ordinance, Articles XXIV, Section 100-241A and 100-243A, and XXIII, Section 100-239.4B, for a building permit to construct structural alterations and increase floor area of principal building with nonconforming front yard and sideyard setbacks and with nonconforming use(s), and to construct deck additions, seaward of existing building setback line (within 75 feet of seawall). Location of Property: 2072 Village Lane, Orient; Parcel No. 1000-24-2-27. WHEREAS, after due notice, a public hearing was held on September 13, 1995, and at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: I. This is an appeal application for a variance based upon the August 1, 1995 Notice of Disapproval issued by the Building Inspector. In an application for a building permit filed on July 11, 1995 with the Building Inspector, the applicants hereby requested permission to construct structural alterations and deck additions to an existing dwelling. The grounds upon which the Notice of Disapproval is disapproved are written as follows: Under Article XI, Sections 100-111 and 100-112A, seasonal multiple-dwelling dwelling is not a permitted use in this district, and building has insufficient front and side yards setbacks. Also under Article XXIV, Section 100-241A, nonconforming uses, buildings shall not be enlarged, altered or extended, and under Section .100-243A a i 6 Page 2 - Appeal No. 4331 Application of DAVID AND CLARE AIR Decision Rendered September 13, 1995 nonconforming building containing a nonconforming use shall not be structurally altered, unless use is changed to a conforming use. Under Article XXIII, Section 100-239.4B proposed construction is less than 75 feet from the sea wall. Action required by the Zoning Board of Appeals. Action also required by the Planning Board as required under Sections 100-250 and 100-253 of the Code. .. . 2. The premises in question is located in the M-1 Marine Zone District. A Certificate of Occupancy under date of July 1, 1993 shows that the building was built prior to April 9, 1957. The building contains five seasonal, unheated dwelling units. 3. Reference is hereby made to the site plan map prepared July 10, 1995 by Samuels and Steelman, Architects showing the existing characteristics of the site, existing building, and proposed alterations and open deck additions. The survey dated May 10, 1993 shows the parcel of a size of 8,412 sq. ft. The building area is shown on the site plan map to be 1,878 sq. ft., for a total lot coverage of 23.95%. 4. The setbacks of the existing porch of the building are shown to be flush with the existing concrete stonewall at its closest northwesterly corner, and at almost seven feet from the concrete stone wall at its furthest southwesterly corner. A new deck area at the first and second floor are proposed westerly of the existing porch to fill-in the open area between the sea wall and the existing porch, together with reconstruction of an existing covered porch. 5. The living area of the dwelling to be renovated and reconstructed is largely on the second floor, for a reduction in the number of units on this level from two to one single living unit, and for the entire building from five living units to four living units. All units are seasonally used from April until November, and are proposed to remain unheated at this time. 6. Section 100-239.4B of the Zoning Code provides that: ".. .All buildings located on lots upon which a bulkhead concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than seventy-five (75) feet from the bulkhead. The following exceptions will apply: (1) Buildings which are proposed landward of existing buildings. . . ." Page 3 - Appeal No. 4331 Application of DAVID AND CLARE AIR Decision Rendered September 13, 1995 7. Section 100-241 of the Zoning Code provides as follows: "Nonconforming Uses. Except as provided hereinafter, nonconforming use of buildings or open land existing . . .on the effective date of this chapter or authorized by a building permit issued prior thereto, regardless of change of title, possession or occupancy or right thereof, may be continued indefinitely, except that such building or use: A. Shall not be enlarged, altered, extended, reconstructed or restored.. ., nor shall any external evidence of such use be increased by any means whatso- ever. . . ." 8. Section 100-243 of the Zoning Code provides that: .. . A. A nonconforming building containing a nonconforming use shall not be enlarged, reconstructed or structurally altered .. . unless the use of such building is changed to a conforming use. 9. The building inspector has determined that the deck addition between the seawall and the existing porch is not landward of the existing building. However, this Board does not agree and hereby reverses that portion of the Building Inspector's determination by interpreting the meaning of Section 100-239.4B1 as follows: New building and similar construction will not require a variance under the zoning code for the reason that such construction is deemed to be landward of the existing sea wall and not at a setback closer than setback already established and measured at the closest point of construction on the same parcel. In this particular project, the closest point of construction from the seawall is the northwesterly corner - which is against the seawall, having a zero setback, and the remainder of the area may be constructed at the same, or greater setback from the existing seawall, bulkhead, riprip or similar structure (subject to obtaining all appropriate building permits). 10. It is also the position of the Board in considering other nonconforming areas of this project that: (a) the circumstances are uniquely related to the property -- the property technically has an established footprint of livable floor area, which footprint is not being altered or enlarged; Page 4 - Appeal No. 4331 Application of DAVID AND CLARE AIR Decision Rendered September 13, 1995 (b) the relief requested is not unreasonable when the density of the nonconforming uses is being reduced from a total of five seasonal units to four seasonal units; (c) it is not uncommon for an owner to request an increase in livable floor area within an existing footprint - whether it be a conforming use or nonconforming use; (d) the relief requested is not substantial in relation to the requirements - a minor 'increase of livable floor area is gained on the second story (see hearing transcript for detailed statements in support of the application); (e) the variance requested does involve a reduction in the unit density; (f) the relief requested will not cause a substantial effect on available governmental facilities since the building will continue to be used seasonally as a residence in each of the four units from April to November each year; (g) the variance will not in turn be adverse to the safety, health, welfare, comfort, convenience, or order of the town, or be adverse to neighboring properties, and the benefit to the applicant is greater when weighed against the health, safety, and welfare of the community; (h) in considering all the above factors, the interests of justice will be served by granting the variance as further noted below. Accordingly, on motion by Member Dinizio, seconded by Member Tortora, it was RESOLVED, to REVERSE the determination made by the Building Inspector pertaining to Section 100-239.4B(1), as described above, and BE IT FURTHER RESOLVED, to GRANT all other relief requested and shown on the site pian perta'ning to the plan dated July 20, 1995, SUBJECT TO THE FOLLOWING CONDITIONS: 1. No parking on right-of-way and "no parking on right-of-way" sign(s) shall be displayed on the applicant's building facing the right-of-way; 2. Building units shall continue to be used seasonally from Page 5 - Appeal No. 4331 Application of DAVID AND CLARE AIR Decision Rendered September 13, 1995 April to November as has existed since prior to 1957 (laws of zoning) . Vote of the Board: Ayes: Messrs. Doyen, Dini.io, Tortora and Goehringer. NAY: Member Villa - objecting to any increase of liveable floor area of the building whatsoever This resolution was duly adopted (4-1). m m a Ik ,-CERA P. GOEHRIN R, CH MAN i �p�p COG I — 1 Town Hall, 53095 Main Road : ti - zZ Fax(S 16)765-1823 P. O. Box 1179 `Q ., Telephone(516) 765-t 8o2 qb Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD , C E R T I F I C A T I O N DATE: -7 Building Permit No . d /cc;, 2 Owner: /JP3 L c/o — (please print) Plumber: / D " i 7 LLV' c�4 (ple se print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ' (Plumbers Si ��, urc) � sworn to before me this �Y day of = Z i/ 19 � Notary Public, County �� Y-'/. 5 � COUNTY OF SUFFOLK ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES MARY E. H1eRERD, M.D., M.P.H. COMMISSIONER July 3, 1995 Thomas Samuels 25235 Main Road Cutchogue, New York 11935 s fNt Re: David Air Property `� SCTM# 1000-29-02-27 _- s{�z Dear Mr. Samuels: �O I am in receipt of your letter concerning the above referenced Property. This is to confirm that this Office would not normally be involved in the review of the sewage disposal or water supply system for an existing building of the type you have described, since the use of the building is not being expanded. However, prior to the issuance of any approvals by the Town of Southold to occupy the renovated building, it is suggested that some determination as to the adequacy of the water supply and sewage disposal system be made. If it is determined that a new sewage disposal or water supply is required, then an application to construct should be made to this Office_ If you have any questions concerning this, please feel free to contact me. Sincerely, a,'( Q' Royal Reynolds, P _E_ Senior Public health Engineer Dlv si ON OF ENVIRONMENTAL QUALITY COUNTY CENTER RIVERHEAD. N.Y. 119013397 852-2100 FORM NO.3 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE, OF DISAPPROVAL Date .1�� . . . . . . . . . . . . . . . . . . . . .. 19 '53 : PLEASE TAKE NOTICE that your application dated .7,.11 . . . . 5� for permit to . . . . . at Location of Property . . 7� /e �. G Hoose No. . . . . . . . . . . . . . . . �� . . Street � � � � � r Hamlet County Tax Map No. 1000 Section . . . . .. . . . . Block . Lot . . R.7 Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . Lot No. i. is returned herewith and disapproved on the following grounds X4 le 44 . . . � � - - '- - - Cd2�'vL /JD-��� 7`:L��� ✓'� � `� Liv'=G-C RV 1/80 B� APPEALS BOARD MEMBERS ®�Q$UfFD�,YC ®fi Southold Town Hall Gerard P. Goehringer, Chairman ® < 53095 Main Road Serge Doyen,Jr. W x P.O.Box 1179 James Dinizio,Jr. O ® Southold, New York 11971 Robert A. Villa yB,�r 0� Fax(516) 765-1823 Lydia A.Tortora Telephone(516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD Re: David Air Building (Multiple Residence) at Orient 10/19/95 1:45 - Tom Samuels, Architect called and asked if there was any restriction with placing a gas-fired fireplace, or similar heating fireplace to heat the owner's apartment upstairs. I agreed to call him back after asking the Chairman. 10/19/95 2:35 p.m. - Chairman (Jerry) called. Jerry said there is absolutely no problem with heating as long as the building is not converted to yearround use (with insulation and permanent yearround construction) , since it was only going to be used from April 1 to November each year. I called Tom Samuels back and confirmed my conversation with Jerry. Tom said that would be great. Z .lk II' PLANNING BOARD MEMBERS %pFFOgf RICHARD G.WARD ®�® C® Town Hall, 53095 Main Road Chairman �� ��� P.O. Box 1179 ® ` j GEORGE RITCHIE LATHAM,JR. Southold,New York 11971 CA Z. Fax(516) 765-3136 j BENNETT ORLOWSKI,JR. WILLIAM J.CREMERS ip ® Telephone(516) 765-1938 j KENNETH L.EDWARDS PLANNING BOARD OFFICE TOWN OF SOUTHOLD TO: Thomas Fisher, Senior Building Inspector FROM: Robert G. Kassner, Site Plan Reviewer r SUBJECT: Air Property Village Lane, Orient SCTM# 1000-24-2-27 DATE: September 19, 1995 The Planning Board has reviewed the above project and has determined that it does not have jurisdiction in this area. A site plan will not be required. a 17 p/1 SEP 9 li !i Albert J. Krupski, President Town Hall j John Holzapfel, Vice President _ y� 53095 Main Road William G. Albertson Cla P.O. Box 1179 Martin H. Garrell �y �� Southold, New York 11971 Peter Wenczel �� Telephone (516) 765-1892 Fax (516) 765-1823 HOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 30; 1995 SaMuels & Steelman Architects 25235 Main Road Cutchogue NY 11935 Re: DAVID AIR SCTM # 37-7-10.2 Dear Mr. Samuels, The following action was taken by the _Board of Trustees at their regular meeting of June 29, 1995: RESOLVED that the Southold Town Board of Trustees approve an Amendment to Permit #4426 to increase the first floor portion of the porch as per revised survey received June 26, 1995. If you have any questions, please call our office. Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh CC. CAC Bldg. Dept. JUL 1995 New York State Department of Environmental Conservation Buiidi%JWTAffl, TgJ!6proN8V�6Ygrk 11790-2356 , s Facsimile (1516)) 444-0373 P k ' 9 ,A/%) F 3L�J�. u4?T t " I Thomas C. Jorling � i MUM OF SO THOLD Commissioner 0 / , Date: 6/ /7/ ;'V Re: /- ,173k- av90 , e 0 00 Dear I/C Based on the informnation you have submitted, the New ycrk State Department of Environmental Conservation has determined that: Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. V y truly yours, *U uty Regional Permit Administrator cc: 4F,'z 3 t "�#, S" ,.E s 3° of""h '`?, ' wss Y "� •�+� y.% Z-F.F `r' .9 .Er b-eyJ-' #-'^> tip. - 'i`Y'a d ,r- 37 ' z�k` rY €r ;� ` go' •m`" ='o-4' t 4W, � rti Im ' xSa <wa ` 'inti Yc`loll X", dy 4 3 ?a 1R' �" J "iLr-?H e ` j .az *'$z ' t 'T ow: Ss } d �2 F N ,. 1.vM, a i-.c ' F �+ sln- c ka>m h ''a�- � r n� ; F ��- } -^_. 7 � b'1 `'`'i"5`'-.�' �'•ri�j r�s�.s` � i'*� ,y.�x'€$+��h�� xc`'j:'� � F" t x z sfi'" sAIM+ s y F'" i'+d2`''�f °'2,• a 1 Y� '+e +Y'' � - �➢ AK , d x . aAzOLL, 'k i 4 r !, en ry - HIS'NOTICE 'MUS' SOS LASE-® DARING ,CO.. STCT�l TOWN TRUSTEES OFFICIE,,TOWNOF SOUTHOLD TEL.: 765-1892 APPLI _ CATION # PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. r SECTION 1: GENERAL PROVISIONS (APPLICANT to read and si )• 3 k� X JUL 19 i'093 1. No work may start until a permit is issued. — 2. The permit may be revoked if an false statements are made herein. Biu DEPT P Y Y TC1�R C5C; S fr 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. S. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE, TO THE BEST OF MY J(NONVLEDG5 TRUE AND ACCURATE. (APPLICANT'S SIGNATUR DATE SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANT) NAME ADDRESS TELEPHONE APPLICANT d' 1%9 G. a w? 07,0-IAJ AD BUILDER ENGINEER �y PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. �!'10V074d; cPct& VLU f-e' a-r- �-z- *h t-fb FDP(93) APPLICATION #e PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure M Residential (1-4 Family) ❑Arddition El Residential (More than 4 Family) Alteration ❑ Non-residential (Floodproofing? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT $ B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) f j After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. SECTION 3: FLOODPLAIN DETERMINATION (.To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4:ADDITIONAL INFORMATION REOUIRED (To be completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: 0 A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. 0 Development pians,drawn to scale,and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement),types of water resistant materials used below the first floor,details of floodproofing of utilities located below the first floor and details of enclosures below the first floor. Also, 0 Subdivision or other development plans(If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). 0 Plans showing the extent of watercourse relocation and/or landform alterations. 0 Top of new fill elevation Ft. NGVD (MSL). 0 Floodproofmg protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. 0 Certification from a registered engineer that the proposed activity in a regulatory floodway %U not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. 0 Other. SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity: A. 0 Is B. 0 Is not in conformance with provisions of Local Law # ' 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED ,DATE If BOX A is checked the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION #_ PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built)Elevation of the top of the lowest floor,including basement (in Coastal High Hazard Areas bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. .Actual (As-Built) Elevation of floodproofing protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES fl NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be comoleted by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area T OWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: Q NEW BUILDING ❑EXISTING BUILDING" ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #_, 19 SIGNED: - DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # 19_, AS MODIFIED BY VARIANCE # DATED SIGNED DATED: C/C(93) THE NEW YORK BOARD OF FIRE UNDERWRITERS D GE &253 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10035 `1D ete"tz` „L `kQGUST 2'S p 199$ 'Application No. on file N452935 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DAVID AIR, 2072 VI1jAGE UNE, PTE#21, ORIENT] MY in the following location; ❑ Basement ❑ 10 Fl. ® 2nd Fl. Section Block Lot was examined on AUGUST 17=2a°?$ and found to be in compliance with the National Electrical Code. FIXTURE RECEPYACLES SWIYCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. I AMT. K.W. I AMT. K.W, AMT. H.P. q 22 i(5 , 4 t 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT,. AMPS: TRANS. AMT. H.P, NO,OF FEET AMi. WATTS i 20 SERVICE DISCONNECT- NO-Of -. _ _ S E . .. R Y. I _. _ _.- C E METER C AMT. AMP, TYPE EQUIP, 1 0 2W0 3W 3 0 3W 3 0 4W 1 NO.OF CC COND. A.W.G. NC.OF HI-LEG A.W.G. NO.OF NEUTRAIE A.W.G. PER 0 OF CC.GOND. OF HI-LEG Of NEUTRAL OTHER APPARATUS: DOROSTE ';,EC. INC. LIC.#2941 L 425 MONS= LkM CUTCIHOG;, , N-T, GENERAL MANAGER � s Per i This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD, OF FIRE UNDERWRITERS � r ?✓'` =:u`s,3 BUREAU OF,.ELECTRICLTY 85 JOHN STREET;NEN/ YORK, NY 10038 i _ Date `-"` I ' t'r f Application No. file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on.the above application number in the premises of D `ID :s p . 277 AQu Lug lK I, in lhefollominq location; ❑ Basement [2 Ist Fl. ❑ 2nd Fl. C+ir'' Section Block Lot uns exarnined on '� + �'-.��� and found to be in compliance with the National Electrical Code. FIXTURE FIXTURESRANGES COOKING OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT.FWORE5CENT OTHER IMT. j KW. I AMT. I K.W. AMT. K.W. SMT. K.W. . AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PTj TIME CLOCKS.. ULL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. On H.P. GAS H.P. AMT. NO. A W.G. AMT. AMP. ANT. AMPS. 7RAN5. AMT. H.P. SYSTEMS AML WATTS - NO.OF FEET SERVICE-DISEONNECT NO.OF S. E. R V. I C E METER --OF CC GOND. A.W.G. A.W.G. A.W.G. AMT. pMP. TYPE EQUIR 1$]V/ 1$3W ]$3W ]$dW PER$ OF CC.COND �' HIcEG OF MI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: L L + ;•`""� i - ,,, GENERAL MANAGER a Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR. BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ELEVATION CERTIFICATE O.M.H.No 3067-0077 Expires May 31, 1993 ' � Ir i9ah FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM /ETT€NTION[LIWot this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to determine theproper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMB). Instructions for completing.this form can be found on the following pages. SECTION A PROPERTY INFORM#TION FOR INSURANCE COMPANY USE BUILDING OWNER'S POLICY NUMBER STREETADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY MAIC NUMBER OTHER DESCRIPTION(Lot and Block Numbers,etc.) CITY STATE ZIP CODE Orienl NV ► Iq�� SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX I 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION (in AO Zones.use depth) 300813 ov48 E 05,111,1`13 A-7EI. Cl 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): ❑TNGVD'29 ❑Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site,indicate the community's BFE: I I .LJ feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level_f . 2(a). FIRM Zones At-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of LJJ_JJ51.10J feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30, VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram,is at an elevation of I I I I I I.LJ feet NGVD(or other FIRM datum—see Section B, Item 7). (c).FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is L LJ.J feet above❑ or below❑ (check One) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is L I .LJ feet above❑ or below❑(check one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Ye El No ElUnknown 3. Indicate the elevation datum system used in determining the above reference level elevations: NGVD'29 ❑ Other(describe under Comments on Page 2). (NOTE. If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.), {/ 4. Elevation reference mark used appears on F�M: (J Yes ❑No (See Instructions on Page 4) 5.The reference level elevation is based on: actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.). 6.The elevation of the lowest grade immediately adjacent to the building is: 1 5 .L3J feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. It the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item.1 is not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: I I .LJ feet NGVD(or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31r MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION ariy � �\ � a,tiiaa✓2w':. ti. \\�✓i4,/ �: ti :.e'•.95ss aa.�.__�i'7y"t'�y e""5,�;�,c""-�'°sv-s'�,'. �""y uX..rp—.+F�' °.w y: r`T.w"'4 ;'Ti^•7sj'�'+�^ '. 1 I �� q� �c��rd Cif S�tath�ld Tcrv�n Trusties '� ; ) a j SOUTHOLD, NEW YORK PERMIT No. ._""1 'l 4( DATE: . 3/30/95 ISSUED TO .......DAVID. AIR..... Pursuant to the provisions of Chapter 615 of the Laws of t << =s 31 the State of New York, 1893; and Chapter 404 of the Laws of the / State of New York 1952; and the Southold Town Ordinance en- Ir, titled "REGULATING AND THE PLACING OF OBSTRUCTIONS E> I, IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM a LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 3/30/95...... J 19. 95._; and in consideration of the sum of $_150..00 paid by t k t Samuels ..& Steelman for..DAVID_AIR t of ....... Orient .......... ........ .. .. N. Y. and subject to the 5 Terms and Conditions , listed on the reverse side hereof, o of Southold Town Trustees authorizes and permits the following: Renovate exist. 1st floor west facing covered porch, renovate / exist. 2nd floor with addit. and roof deck over 1st floor west q facing covered porch. Also Septic system be up to Health Dept.,,,, q standards. Orient Harbor all in accordance with the detailed specifications as presented in ra \ { the originating application. G .ffi IN WITNESS WHEREOF, The said Board of Trustees here- f by causes its Corporate Seal to be affixed, and these presents to j a' be subscribed by a -majority of the said Board as of this date. I , 1 ii Trus ees w ew3 y F 2 r .k`tx c < rz r eu T s Y '77.3% / .; SECTION E CERTIFICATION This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30,AE,AH,A(with BFE),V1—V30,VE,and V (with BFE)is required. Community officials who are authorized by local law or ordinance to provide floodplain management information;may also sign the certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building official,a property owner,or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8-Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment,area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not included in the certification under Comments below. The diagram number,Section C, It Still be entered. LANDS f . + I certify that the information in Sections B and C on this certificate represents my a data available. I understand that any false statement may be punishable by fine or imprisonmen St on 1001, 7U • F ,�, r6r V `aid y� p CERTIFIER'S NAME LICENS BER Attig$eg) yr at'1 (John -f M2+-Ie( TITLE CVPANY NAME ly F�resi�jent � �1i . �l rr � A . E� "Bo q®� CITY STATE ZIP SIGNATURE c h DATE q,JNL, S z)1G1S. 5020 Copies ShOU'ld be made of is&atificate for:1)community official,2)insurance agent/company,and 3)building owner. COMMENTS: ON _ WITH ON PILES, SLAB BASEMENT PIERS,ON COLUMNS A V A A V '.. ZONES ZONES ZONES ZONES ZONES REFERENCE REFEREN BASE LEVEL flEFEflENCE LEVVEL FLCOO LEVEL ELEVATION - �Y k BASE BASE ADJACENT I, flEFEflENCE fLWO ROOD ELEVATION gEfENENCE gpJgCENT GRADE' LEVEL FLtlVPTION LEVLL GNAUE i I GRADE { The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 ill TERMS and CONDITIONS = The Permittee DAVID ATR residing at 2072 Village Lane Orient N. Y., as part of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 74 mos. which is considered to be the 'estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that air& orization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its.agents, and non-compliance with the provisions of the originating application, may be cause for, revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. G. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations l in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated with expenses to the Town of Southold. l 8. That the said Board will be notified by the Permittee of the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sap- plemental to this permit which may be subject to revoke upon failure to obtain same. '6S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ /ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA KS: DATE Y Zg INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REM RKS-. DATE 3 7 INSPECTOR i✓�� BUILDING BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PL G® [ ] FOUNDATION 2ND E ] INSUL [ ] FRAMING E IN E ] FIREPLACE & CHIMNEY ®ATE INSPECTOR M-18®2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRA G [ ] FINAL [ - FIREPLACE & CHIMNEY REMARKS: 71 DATE C® yg INSPECTO 765-Z8®2 BUILDING DEPT. INSPECTION l FOUNDATION IST [ ] ROUGH PL G. [ ] FOUNDATION 2ND [ Vie INSULATION ] FRAMING [ l FINAL. [ } FIREPLACE & CHIMNEV REMARKS: DATE �/ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION { ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING { ] FINAL { ] FIREPLACE A CHIMNEY REMARKS: DATE INSPECTOR 765-1s®Z BUILDING DEPT. r4spt(;T WN ] ®UN ATION IST ] ROUGH PLGG. L ] FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS a j CID ®AT INSPECTOR l Tllil>) IN iI'L(YI'1.ON RRPoR'1' DAT ` _.. — - _ c ynMl Nr- "T I ` FOUNDATION ONO --- - -_ ---_� ---__ - sk --il ROUGD PRANK 6 li— rt.urinCNG IT IT IL /7�p Iii , - -- - � " TNSllC.A'rION PER N. Y. S'I'ATI's RNKRGY __ _.__Ii ! /�'�' '�"'P _ _• ®/C (ADR jl II- ----neol -- /' I FT NAT, IT 7 AI'IUI I IONAf ('01.11I --- .; BOARD OF HEALTH .... . . . , FORMN0. 1 3 SETS OF PLAYS j TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OT I FY l , r� CALL Ea amined . �. . . . . . . . , 19 �J MAIL TO : Approved . . . . . . . . . , . . .. 19 . . . Permit No. . . . . . Disapproved a/c . . . �. Ci . . � . �. . . . . (Building Inspector) ' APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 ets of plans, accurate plot plan to scale. Fee according to'schedule. 'Ib. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- . :ation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the,Building Department for the issuance of a Building Permit pursuant to the. 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ;. droit authorized inspectors on premises and in building for necessary inspec ott ns. ! . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) .... s..ic. . a re , (Mailing address of applicant) //1?55 hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Vame of owner of premises . . � sv�. . � � !�.a, , , ` �. . , , , . , , (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer.- . . . . . I . . . . . . . . . . . . . . . . : . . . . . . . . (Name and title of corporate officer) Builder's License No. 15141. . . . . . . . . . . . JUL 1 Plumber's License No. . . . . . . . . .. . . . . . . . . . . . . . . . . . f r Electrician's License No. �J. . . . . ... . . . . . . . Other Trade's License No. . . ✓.A. . . . . . . . . . . . Location of land on which proposed work will be done. . ,Z®7? .. e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` . .�°. . . . . . . . ./195.x. . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section , . . . .?'f. .,. . . . . . . Block . . . .� . . . . . . . . . . . . Lot..., .�` ....... . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: i a. Existing use and occupancy . . . . . >/P✓�`` �� . . . .�. . . . ��d����. . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy � " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,,,.,.,. . . 3. Nature of work (check which applicable): New Building . . Repair ReAddition . . . ?! . . . . . Alteration . . !. . , , , , Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . , 4. Estimated Cost . . . . . ,��i R9,® Fee . . . . . . (Description) : . . . . . . . . . . . . (to be paid on filing this application 5. If dwelling, number of dwelling units . . . Number of dwelling units on each floor l57 ..cJ If garage, number of cars . . . . , . /. . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures,if an Front . ..:` F7< Y: p. . . . . . . Rear . .—. .3�/ 7 . Depth : ' % ..T. . Height�:C? ,f� .� • . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . Dimensions�f same structure with alterations or additions: Front . '� � FT . . Y y� I.�� ' _Z 6 F�+ . . . . . . Rear . . . Depth . : . . . .�f. ./. . . . . . . . . Height . . .•. . . . . . , • • • • • . . • . . . . Number of Stories . . . .�- 8. Dimensions of entire new construction: Front . . . . . . . . Height Rear . . . . . . . . Depth g • • • • • • • • • . • . . . NumberofStories . . . • 9. Size of lot: Front . .. .�F �✓- : . rT. . . . Rear . ' _ . . . . : . . . . .. 10. Date of Purchase ' • ' ' `" ' ' /. . .F... . . . Depth . . `?®.® T . . . . . . . . . . . . . . . : . . .: . . . . . . . : . Name of Former Owner . : . . : . 1 1, Zone or use district in which premises are situated . . . . . ,� . egultion . . . . . . . . . . . : _ 12. Does proposed construction violate any zoning law, ordinance or regulation: , . , , ,., � � � ' • 13. Will lot be regraded sl® • • • • . . .. . . . . . . . • • • • . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . � �}��' , Addresses. . . . . . . . . . . . . . . . 7 t/� Phone No. 2?Z Y?s✓,'167, Name of Architect �' 6Jz$ /$tJ Addiess ?? ,. d✓. ? t • , 'Phone No. T'-fe lk' , Name of Contractor . . . . . . . . 4a ... . . . . . . . . . . . . . . . Address . .. . . . . . . . . . . . . . . Phone No. :. . . . . . . 15. Is this property within 300 feet of a tidal wetland? Yes. . { No. . . . . . . .. *If yes„ Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing-or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . S.S . .4P.�? 4., 'aY' .W05rop laL . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .1 bove named: leis the . . . . . . . . . . . . . . . . . . . . . . Ee . . . (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized :to perform or have performed the said work and to make and file this ?pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the v`ork will be performed in the manner set forth in the application filed therewith. ;w dm to before me this �G . . . . .�.... .day of. . / .f.. . . . . . . . ., 19 ntpryPUbG ✓(l �G�. . . . Count LINA FOROSICH el 1401my Me,Slate of New York . . . . . . . . . . . . No./985863.SuM County . . . . . . . . . . . . . Tom E091Sap.3,t9;xle (Signature ofa pl€: _ i X.3 I i v 2 war soon skwwnwn ,T': A.. it: " * p £1a . Lr} Inc Jj 0Elit.. 4x { , 3i: T{ yn f G R-, 7 /" J7 1,0 q jj- �, {5 J y i � W Y4 4 `$ 70 }fl r j, . r r f 4 y � tlr� i�Y V t ( `�,R --i 1 fAl jjn +Y y3 iJ ♦•.. J -n` a x _ r j _ 'S F - tinawiari eanRe MwaddMon - ,... _fothlssurmytszvbladonbt - `Section 7208 otihe NewYwkSme V, EdUCWWL�B* GOPias WfNs snmrryrnaanm hmm9 �', The WrW suhrByOfsWredsdala F_'- B r�` �: emhmmdpitsMnotmco'reiaarea -`"-"'--.•»`-.._..,�• "" T"'s""'"-'""""""'w ., ,. R L p - bb§nvaBdlfiMWp1F �. - r GueRMaBlltndClYdMRonshall run d,%x _ �- wnlytOgNtl rMforubm ft=MY iS i r I rBipmW0nnw _ '�. gt . tofisesign a0fthekndmgms0 ,- .. 1 ,{ fution.Guarameea are.not tr*Sfe ---- t6adN1odetsrstitutwnsarsuUsepuent - _. trvmers.'. � ,{yam z r Y 3 . 0iozyll t A6 P Or : avf t< ,� pF Nc CO . HSep AN➢9JP, As''. ... NW elm IV 77 it 'a W e' _ - ra r{ two's z SITE DA Rt�ls clew sig/ SCTMN 1000 - 24 - 2 - 27 r PROP)ERTY: 2072 Village Lane ADDRESS Oreint, N.Y. 11957 m OWNER: David & Clare L. Air 8 Beach Street New York, New York 10013 Tel # 212 - 925-7867 - I ZONING: M - 1 SITE: 7,840 8 sq. ft ,ii919 AREA L m_ Town'u�; � BUILDING: 1,878 sq. ft. --==L�,__ AREA LOT: 23.95% COVERAGE Y UJI SURVEYOR: Roderick Van Tuyl >- Greenport, N Y. 11944 U 3 License # LS 25626 CD W Z I / ural /, 6 C V♦ O SITE Jnnr: vc '' . I • „ \, CD 3 7 :- N� O 1 OCCUPANCY OR ��� ov�� , USE IS UNLAWFUL WITHOUT CERTIFICATE ' � Z . nI�j I° N 80.47' G_ OF OCCUPANCY ��✓ �� __ 33 -- E%I�TNG m N ¢ m _\ FT 1 �cEb'p+f��1�U L1 I 4-4^f 1, 9EPTIc � o o if \ TMJ w- w z z I {213 GSR i m � z3 - i PIReT i �' ii � Uw • � f ] o UKKA RITFRSCEp11RgTE / FL ooR E�clb f N- S ' CATION PLUMBER CERTIFIexsTN �. - t� ¢< i-w • ON LEAD CONTENT BEFORE • s a p CERTIFICATE OF OCCUPANCY OAAS NOTEDATE: P.ItSOLDER USED IN WATER SUPPLY SYSTEM CANNOT NOTIFY BUILDING DY AT } S EXCEED 2/10 of 1% LEAD. 765- 2 s AM To 4 M FOR THE JJJ///�O' J 5 Fr FOLLOWING INSPECTIONS: F-x isT L 1. FOUNDATION - TWO REQUIREDFOR POURED CONCRETE2. ROUGH - FRAMING PLUMBING ,n P / %18TINCq laT .R Fr , f: SSEaLD PLUMBING 3. INSULATION ULATION �I/ «y Ep r- '� ,ALL PLUMBING WASTE TO gE R6CohIs•TRLbTEl7 , �-; Q./- - Z o' i �, i &WATER LINES NEED 4, FINAL - CONSTRUCTION MUST �� G 9E COMPLETE FOR C.O. n y TEISTING BEFORE COVERING ALL CONSTRUCTION SHALL MEET f THE REQUIREMENTS OF THE N.Y. I STATE CONSTRUCTION & ENERGY ry 250 FLR .9TizLcT1J'FzG.,� - o- -fD ibE mWLT OVGIZ II CODES. NOT RESPONSIBLE FOR /p- covEREI7 F� RGH DESIGN OACONSTRU NEWFIS 1 , i N copper r bingdistributing Is used / � j u torr water distributing systtam; piping shall be I 1JE a IaooF ovr Project No: q } / of types K or L only To 88 6L11 LT oV>s2 up 6 r1 TIC---. mvErFsED f�oRcH Ti+ k v Drawn By: IJT j1c16TIhICq f_ Checked By: T8 FIR8T FLaofL t cE651M01-� \ �/���,�/YA ///� (� P L✓c I� "\S'� / Date: 15 j � AIJ Scale: 9 oTEM / 0 E:�cIBTW C� UI.Y7ER dl] RoUI.ID �T�fZ Sheet Title: Y1 / �I-LLL"Oc.�-TED OFF �+ 91 TE.-Lip L1 1.lD SITE / �eA� J PLAN r—Go9�! 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